Individual provider Active NPI

Larry Valdes, CEO

  • Assisted Living Facility
  • Tampa, FL
National Provider Identifier
1306361266
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Practice address
4402 W Minnehaha St
Tampa, FL 33614
Phone
(813) 841-9823
Fax
(813) 349-0029
NPI assigned
Aug 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4402 W Minnehaha St
Tampa, FL 33614

Mailing address

4402 W Minnehaha St
Tampa, FL 33614-3638
Phone (813) 841-9823

Other identifiers 1

IdentifierTypeStateIssuer
33614MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Larry'S Family 1 Care Alf, LLC Assisted Living Facility CurrentSince Jul 24, 2022 Accepting new patients
Larry'S Family2 Care Alf, LLC Assisted Living Facility Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306361266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 W MINNEHAHA ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143638",
            "telephone_number": "813-841-9823",
            "fax_number": "813-349-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 W MINNEHAHA ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-841-9823",
            "fax_number": "813-349-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "LARRY",
        "name_prefix": "Mr.",
        "credential": "CEO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33614",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.